Provider Demographics
NPI:1790356327
Name:HAMIL, DESIREE ELAYNE (APRN FNP-C)
Entity Type:Individual
Prefix:
First Name:DESIREE
Middle Name:ELAYNE
Last Name:HAMIL
Suffix:
Gender:F
Credentials:APRN FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:609 S CAROLINA ST
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79106-8721
Mailing Address - Country:US
Mailing Address - Phone:806-231-0364
Mailing Address - Fax:
Practice Address - Street 1:609 S CAROLINA ST
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79106-8721
Practice Address - Country:US
Practice Address - Phone:806-231-0364
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-06
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1045767363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXF03211306OtherAANP CERTIFICATION